Provider Demographics
NPI:1447237706
Name:DURHAM, JAMES MATTHEW (DC)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:MATTHEW
Last Name:DURHAM
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 ELLIS AVE
Mailing Address - Street 2:
Mailing Address - City:ABBEVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29620-2114
Mailing Address - Country:US
Mailing Address - Phone:864-366-7777
Mailing Address - Fax:864-366-7778
Practice Address - Street 1:102 ELLIS AVE
Practice Address - Street 2:
Practice Address - City:ABBEVILLE
Practice Address - State:SC
Practice Address - Zip Code:29620-2114
Practice Address - Country:US
Practice Address - Phone:864-366-7777
Practice Address - Fax:864-366-7778
Is Sole Proprietor?:No
Enumeration Date:2005-12-28
Last Update Date:2012-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1154111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCU28236Medicare UPIN